Abstract :

Sub trochanteric femur fractures are the most devastating injuries and are one of the leading causes of hospital admissions. Most of the fractures in the elderly results from trivial fall while in the younger age group it is mainly due to high energy trauma. In this study of 25 patients with complex proximal femur fractures, 15 were male and 10 were female with mean age being 60 years.75% of the cases in the study were due to road traffic accidents and 25% cases were due to low energy trauma from trivial fall. Right side more affected. Communited sub trochanteric fracture constituted 19 cases and sub trochanteric fracture with proximal femur extension in 6 cases. Mean duration of hospital stay was 10 days. Mean time for full weight bearing was 16 weeks and 90% of cases showed bony union at 6 months follow up. Good to excellent results were seen in 95% of cases (functional outcome).At present we consider that proximal femoral LC P is a satisfactory method of treatment in sub trochanteric femur fractures with comminution and osteoporosis. CONCLUSION Sub trochanteric femur fracture is common in young due to high velocity trauma and in the elderly due to osteoporosis. As the fracture is more common in the elderly, early reduction and internal fixation increases patient comfort, facilitates nursing care, helps in early mobilization of the patient and decreases the duration of hospitalization. As the incidence of comminution is high, these fractures may require a stable reduction and internal fixation. Proximal femoral LCP is a good method for Sub trochanteric femur fractures in the elderly patients especially for severely communited fracture and with osteoporosis. Proximal femoral LCP provides the surgeon with flexibility to achieve angular stability or axial compression with plate to bone apposition. The procedure may be adopted in patient with communited fractures, where conventional dynamic hip screw fixation is difficult and not adviced and there is need for adequate post-op immobilization to prevent implant failure complications. Proximal femoral LCP provides the surgeon with flexibility to achieve angular stability or axial compression with plate to bone apposition. Few of the disadvantages associated with PF LCP are re latively difficult operative technique and mechanical hardware failure with varus collapse. In light of these observations, we conclude that the Proximal femoral LCP, despite few unfavorable results and complications, is a satisfactory method of treatmen t in subtrochanteric fractures with severe comminution and osteoporosis. It requires closed monitoring during pre, intra, post-operative period to avoid complications which can be managed.

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